0001209191-21-069389.txt : 20211214
0001209191-21-069389.hdr.sgml : 20211214
20211214133642
ACCESSION NUMBER: 0001209191-21-069389
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211213
FILED AS OF DATE: 20211214
DATE AS OF CHANGE: 20211214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Yost Mark J.
CENTRAL INDEX KEY: 0001740767
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-04714
FILM NUMBER: 211490412
MAIL ADDRESS:
STREET 1: C/O CHAMPION ENTERPRISES HOLDINGS LLC
STREET 2: 755 W BIG BEAVER RD, #1000
CITY: TROY
STATE: MI
ZIP: 48084
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Skyline Champion Corp
CENTRAL INDEX KEY: 0000090896
STANDARD INDUSTRIAL CLASSIFICATION: MOBILE HOMES [2451]
IRS NUMBER: 351038277
STATE OF INCORPORATION: IN
FISCAL YEAR END: 0326
BUSINESS ADDRESS:
STREET 1: 755 W BIG BEAVER ROAD
STREET 2: SUITE 1000
CITY: TROY
STATE: MI
ZIP: 48084
BUSINESS PHONE: 248 614 8211
MAIL ADDRESS:
STREET 1: 755 W BIG BEAVER ROAD
STREET 2: SUITE 1000
CITY: TROY
STATE: MI
ZIP: 48084
FORMER COMPANY:
FORMER CONFORMED NAME: SKYLINE CORP
DATE OF NAME CHANGE: 19920703
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-12-13
0
0000090896
Skyline Champion Corp
SKY
0001740767
Yost Mark J.
C/O SKYLINE CHAMPION CORPORATION
755 W. BIG BEAVER RD., SUITE 1000
TROY
MI
48084
1
1
0
0
CEO & President
Common Stock
2021-12-13
4
G
0
144000
0.00
D
126985
D
Common Stock
2021-12-13
4
G
0
144000
0.00
A
144000
I
As Investment Manager of a SLAT
Common Stock
66466
I
As spouse to account holder
Represents a bona fide gift of shares as a contribution to an irrevocable Spousal Lifetime Access Trust by Reporting Person, over which Reporting Person retains sole investment authority. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer or the staff of the Securities and Exchange Commission, upon request, full information regarding the nature of the bona fide gift and the Trust to which the shares were contributed.
Since the date of the last ownership form of the Reporting Person, 66,466 shares have been transferred and are now indirectly held by the Reporting Person in an account in the name of the Reporting Person's spouse.
/s/ Caren A. Ries, Attorney-in-Fact
2021-12-14